NEW YORK (Reuters Health) - The success rate of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) is improved by performing coronary computed tomography angiography (CCTA) beforehand, with numerically fewer instances of coronary perforation and periprocedural myocardial infarction, according to results of a randomized controlled trial.
The CCTA-CTO study assessed the value of preprocedural CCTA on the success rate of CTO-PCI in 400 patients; 200 received PCI with preprocedural CCTA and 200 did not (the angiography-guided control group).
The success rate of CTO-PCI was higher in the CCTA-guided group compared with the control group (93.5% vs. 84.0%; P=0.003), report Dr. Sung-Jin Hong of Yonsei University College of Medicine, in Seoul, South Korea, and colleagues.
Patients with CTO who had a high J-CTO score (2 or higher) saw higher success rates than those who did not (P for interaction=0.035).
Coronary perforations occurred in two patients (1%) in the CCTA group and eight patients (4%) in the angiography-guided group (P=0.055).
No patient in the CCTA group suffered periprocedural MI but this occurred in four patients (2%) in the angiography-guided group (P=0.123).
There were no between-group differences in total procedure and fluoroscopic times, or in the occurrence of cardiac death, target-vessel-related MI, or target-vessel revascularization at one year.
